People keep confusing Universal health care with single payer government funded health care… you need to be more clear. Are you proposing the Japanese version where more than 3500 private health insurance companies compete to provide health care to all Japanese? Are you suggesting we expand the VA system to cover everyone like they do in England with NHS or are you proposing they have a Medicare for All system in France where over 85% of people have a supplemental private insurance company. Or are you suggesting we go with the US model of universal healthcare which provides access to health care based on age, employment status, income, and other variables, but allow people to opt out if they chose but mandates they get health care if they have a life threatening condition.
Perhaps the biggest advantage of the US health care system is it is the most “progressive” funded health care system in the world. Most countries fund health care using payroll deductions funded at a specified rate. Similar approaches in the US would require individuals pay an additional 15% of their income (not what they are already paying in payroll taxes) in the form of payroll taxes to fund our health care. Not very progressive, though better than paying the absolute premiums.
In the US, employers fund a bit over 30% of health care. On average the wealthy own the businesses directly or through stock in the companies so its fair to say, the wealthy fund 30% of our health care right off the top. The government funds 40% of our health care. Most of this is collected in the form of taxes on wages like most single payer systems and the balance funded through other tax schemes. The last 30% or so is funded in the form of individuals paying for their own health care (often subsidized by the government under ObamaCare). This includes deductibles, co-pays, etc.
The reader should know most countries with “universal health care” require citizens to pay 30% of the cost of health care through co-pays, which is why most citizens by supplemental private insurance like they do in this country with Medicare. So the the real question is not whether this Coronavirus will force us to reconsider universal health care or whether we will change the universal health care system we are under.
Switching from our system to a government single payer system as practiced by most countries would shift a substantial burden of our health care costs from corporations to the citizens. It would simplify are system, everyone pays more taxes and the corporations pay less and no one would have the option of not participating (under the original ObamaCare proposal people could opt out with a penalty and many did… today there is no penalty, so even more do). But to be clear, people opt out of universal health care, it is not that it is not available. If you argue it is unaffordable, you have a good point…
The primarily young and healthy people that opt out today because health care is expensive are not suddenly going to have more money when the government takes 15% of their income for health care (remember we still provide advanced premium credits for low income workers that do not get health insurance at work). Many other low income workers that do get health care at work will pay a great deal more for health care.
The media is promoting single payer government funded health care because it is the “liberal” thing to do. But it really does not make sense. Proof. Most European countries are slowly shifting more and more health care financial responsibilities back to individuals in the form of higher cost sharing which is leading to a rise of private health insurance companies in Europe. In addition, service access is declining in many markets since government reimbursement cuts have reduced the “capacity of their health care systems. “ The grass is always greener on the other side of the fence.”
But is there an alternative to single payer government funded healthcare when we face an emergency like the Corona-virus. The truth is that with or without government funded health care the issue won’t be funding but rather “access” to the medical resources necessary to treat a national medical emergency. We have that today and it is working pretty well. It is called FEMA. While traditionally deployed for natural disasters, it is being used to manage much of the resource allocations being deployed and then redeployed around the nation.
We do need to reconsider making adding a permanent “arm” to FEMA focused at dealing with potential medical emergencies that can shift resources into “hot spots”. Otherwise the amount of excess capacity, we will need in our health care system to handle spikes in local demand would take our already expensive health care system and make it far more expensive. It could also be funded to avoid medical emergencies by funding it to pay for all Federally approved vaccines, so that everyone could get vaccines that the government deems necessary to avoid a medical emergency.
Re-engineering our health care system funding to deal with national medical emergencies would put a huge financial burden on most citizens with only incremental at best coverage outcomes. On the other hand, supporting a coordinated approach to dealing with medical emergencies and their avoidance is a far more focused way of dealing with future medical emergencies, that would add some additional cost, but arguably would save money in the long run. Let’s do the smart thing… and not react in a knee jerk way… let’s figure out how better to prepare for future medical emergencies and not as they say use a crisis to push bad public policy.
